Moreover, tick density and pathogen distribution can vary widely between and within parks in the same area, resulting in spatial heterogeneities in the tick hazard. However, these studies only use acarological measures and do not examine human usage (e.g., time spent in different park areas and habitats) to assess exposure. Human exposure risk to ticks and pathogens has been previously estimated in public green spaces by using a drag cloth sampling technique and determining the infected tick encounter rate per hour or tick encounter distance (number of meters passed until encountering a tick) on frequently used trails. Elucidating tick encounter risk to these additional tick species in parks is important to understand visitor exposure to new regional pathogens and if concurrent exposure of humans to these additional tick species with different questing behaviors, can prompt changes in human behavior (i.e., adaptive responses) that can impact human- Ixodes encounter rates.Įstimating tick encounters in public green spaces, including neighborhoods, states, and national parks presents many challenges. Furthermore, other tick species are expanding in distribution, such as Amblyomma americanum, an aggressive human biter that transmits Ehrlichia chaffeensis, Francisella tularensis, Heartland Virus, and Haemaphysalis longicornis, the more newly invasive tick that transmits Severe Fever with Thrombocytopenia Syndrome Virus in its native range. However, while links between tick density in residential yards and human disease have been extensively documented, there is little and only passive information on what proportion of infectious tick exposures occur in parks. burgdorferi in eastern United States, occurs outdoors in proximity to natural or peridomestic wooded settings. avoidance behaviors and use of personal protective measures). Thus, Lyme disease risk depends on both the density of infected ticks, typically nymphs (hereafter, tick hazard) and on human behaviors affecting exposure (e.g. The epidemiology of Lyme disease is complex, and Borrelia burgdorferi sensu stricto (the primary Lyme disease-causing bacterium in North America) is maintained in enzootic transmission cycles between Ixodes scapularis ticks and multiple hosts humans are considered incidental hosts. An estimated 476,000 cases of Lyme disease occur in the United States each year, predominately in the Northeast, Mid-Atlantic, and Upper-Midwest regions. Vector-borne diseases are an increasing public health challenge in the United States, with tick-borne diseases accounting for the majority (77%) of all cases reported in the last decade, of which more than 80% were Lyme disease cases. Our research is a first step towards identifying visitor risk, attitudes, and practices that could be targeted by optimized messaging strategies for tick bite prevention among park visitors. Furthermore, we showed that people’s KAP did not change across parks even if parks represented different exposure risks. However, this exposure risk varied among demographic groups, the type of activities and parks, with a higher probability of human-tick encounters in trails compared to open spaces. Conclusionsīy integrating acarological indices with park visitor behaviors, we found a mismatch between areas with higher tick densities and areas more frequently used by park visitors. People were most likely to practice tick checks if they knew multiple prevention methods and perceived a high likelihood of tick encounter. Consequently, many visitors did not conduct tick checks. The KAP survey revealed that most respondents ( N = 190) identified parks as the main location for tick exposure, but most believed they had minimal risk for tick encounter. For all species, the density of nymphs was greatest in unmaintained herbaceous habitats and trails, however, the fewest people entered these hazardous locations. Three tick species ( Ixodes scapularis, Amblyomma americanum and Haemaphysalis longicornis) were collected. To assess visitors’ tick prevention behaviors, a knowledge, attitude, and practices (KAP) survey was administered. We integrated the time spent in each location by park visitors and the tick density to estimate the probability of human-tick encounter. ![]() Human behavior was assessed by observations of time spent and activity type in each site. ![]() We conducted tick sampling in three parks, across three site types (open spaces, the edge of open spaces, and trails) and three within-park habitats (maintained grass, unmaintained herbaceous, and leaf litter) to estimate tick density during May-August 2019. We sought to understand, for the first time, visitors’ exposure risk and drivers of tick-preventative behavior in three popular parks on Staten Island, New York City, NY, USA, by integrating tick hazard and park visitors’ behaviors, risk perceptions and knowledge. ![]() Public green spaces are important for human health, but they may expose visitors to ticks and tick-borne pathogens.
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